Hives Overview

Having hives can make you feel like you've been the all-you-can-eat buffet for a group of really hungry mosquitoes. And, as if having really itchy welts isn't bad enough, hives can burn and sting. Just what makes these nasty bumps appear?

Hives, also referred to as "urticaria," can be acute or chronic. If you have hives that last less than six weeks, they are acute; if they last more than six weeks, they are chronic. In general, acute hives are easier to treat because they tend to have common causes. Chronic hives, which are less common than acute hives, are trickier to identify and treat [source: American Academy of Dermatology].

While most hives will go away on their own, some do not. So it can be a good idea to make an appointment with your family physician or dermatologist. Doctors can perform a number of tests to try to determine the cause of your hives, including blood tests and allergy skin tests [source: Mayo Clinic].

Sometimes what you think may be hives could be its cousin, angioedema. The main difference between the two conditions is that angioedema occurs deeper in your skin than hives do. It tends to cause swelling around your eyes and mouth but it can also affect your hands, feet and genitals. In rare cases, angioedema or hives can be dangerous because they can cause swelling in your throat, which in a severe case can interfere with your breathing. If you feel like your throat is swelling or closing up, you're finding it difficult to breathe or you're feeling lightheaded, you should seek emergency treatment [source: Mayo Clinic].

By now, besides feeling a little itchy, you're probably wondering what causes hives in the first place, and how to rid of get them if you get them. Keep reading to find out.

Causes of Hives

Generally, hives are caused when your body releases the chemical histamine in reaction to something, often in response to an allergic reaction.

Some causes of hives include:

Food -- One of the most common causes of hives is food. Some foods are more likely to cause an allergic reaction than others are. In fact, 90 percent of hives are caused by milk, soy, eggs, nuts, shellfish or wheat. Other common triggers include chocolate and food additives like sulfites and salicylates. If you have a food trigger, you can simply eliminate it from your diet.

Medications -- Like food, medications are common culprits of hives, and some are more apt to cause allergies than others are. Common triggers include painkillers like ibuprofen, aspirin and codeine. Other offenders include certain antibiotics and blood pressure medications. If you have an allergic reaction to a medication you are taking and you get hives, talk to your doctor before deciding what action to take.

Outside sources -- Hives caused by outside influences like exercise, sun, cold or heat are called physical urticarias. If you get this kind of hives, you'll see the bumps within an hour of exposure.

In as much as there are many possible causes for hives, there also are many treatments for it. To discover what treatments work best for different kinds of hives, read on.

Finding the Trigger

If you've ever had hives, you probably want to keep future outbreaks away. Your first step is to try to figure out the trigger. Try keeping a diary of your outbreaks, particularly if you think something you're eating might be the cause. If you can determine what you think the trigger is, try eliminating it and see what happens [source: Mayo Clinic].

Treating Hives

The first option for treating your hives is to do nothing. While the itching may be annoying, if it's a mild enough case and it doesn't really bother you, then you can simply ride it out, waiting to see if your hives will clear up on their own.

However, if your hives aren't mild and they are causing you distress, you should talk to your general physician or dermatologist about using an antihistamine. There are a number of over-the-counter antihistamines to choose from, as well as a range of prescription drugs.

Some common over-the-counter antihistamines include diphenhydramine and chlorpheniramine. And you can get over-the-counter versions of loratadine and cetirizine, which used to be prescription-only medications. Antihistamines that you can still only get with a prescription include fexofenadine, hydroxyzine, desloratadine and levocetirizine [source: Mayo Clinic]. Some antihistamines can make you drowsy, so make sure you ask your doctor about any potential side effects.

How do antihistamines work? Histamines are kind of like people vying to go to a sold-out concert -- in this case, the concert venue is your receptor site, and the histamines want an all-access pass. When your antihistamines work, they are taking up all the space at your receptor site concert venue, so the histamines can't get in. While your antihistamines are inside enjoying the concert, the histamines are left hanging outside the venue. This is a good thing because it is the histamines that are causing the allergic reaction -- in this case, the hives [source: WebMD].

In rare and special cases, your doctor may instruct you to carry an EpiPen, a portable, injectable epinephrine device for emergencies. If you have severe hives or hives that occur internally, an EpiPen could save your life in the event the swelling increases to the point where can no longer breathe [source: Saini].

Are there other options to treat hives besides using over-the-counter and prescription medications? Keep reading to learn about natural remedies for hives.

Heartburn and Hives

Sometimes if your hives don't respond well to regular antihistamines, your doctor might tell you to try taking heartburn medication. Your body has a second kind of histamine receptor site that's not only found in your skin but also in your stomach. If a regular antihistamine isn't doing the trick, a heartburn medication could help by blocking this second kind of receptor site [source: Saini].

Natural Treatments for Hives

Some people prefer the "natural" route to curing their hives instead of taking over-the-counter or prescription drugs. But what natural remedies are there for hives?

Soaking in a cool bath can soothe the itching. Adding baking soda and/or oatmeal might make that bath even better. You can use uncooked, regular oatmeal or oatmeal that's made exclusively for the bath (sometimes called "colloidal" oatmeal). Don't have time for a bath? A cool, wet compress should work too [source: Mayo Clinic].

Acupuncture is one of the most popular alternative-medicine choices for the treatment of hives -- some people find it very effective [source: Saini]. Although there's some debate on whether acupuncture works (as well as how it works), one theory suggests that acupuncture affects the nervous system, working with the body's signaling systems to promote healing [source: Institute for Traditional Medicine].

If the baths aren't working and the thought of acupuncture is a little scary, you could give herbs, supplements and essential oils a try. Some herbalists recommend quercitin, which is a natural antihistamine found in leafy green vegetables, for treating hives [source: American Chronicle]. Taking vitamin C has been linked to lowering histamine levels, which in turn might help prevent hives [source: How Stuff Works]. Chamomile, lavender or sandalwood oils are used to soothe hives [source: American Chronicle]. You may find value in the way these oils smell, too. Some people use essential oils to aid relaxation when they're feeling stressed -- being in a constant state of itchiness could certainly be stressful.

Of course, if you're already following the care of a physician, talk to your doctor before starting any natural therapies to see how it will affect your overall treatment strategy.

Now that you know how regular hives are treated, you might be wondering how to help chronic hives. Continue reading to find out.

Keeping It Cool

When you raise your body temperature, you can create conditions favorable to hives. Whether you're out in the sun, exercising at the gym or even taking a hot shower, all that extra heat can trigger your cells to produce histamine, the chemical that makes you itch. Plus, if you're warm, more blood is flowing to your skin and that just makes the situation worse [source: Saini]. So, whether you're trying to manage an active case of hives or you're hoping to keep a case at bay, try keeping yourself from overheating by wearing loose clothing and keeping the room temperature cool [source: WebMD].

Chronic Hives

Chronic hives can be a real trial to people who suffer from them. Not only do chronic hives last for more than six weeks, they can last for months or even years. And even if they do go away, they're not necessarily gone forever. In fact, estimates say that 40 percent of people with chronic hives will have at least one more outbreak in their lives [source: American Academy of Allergy, Asthma & Immunology]. What's even more perplexing is that in more than 80 percent of cases, the cause of chronic hives is never discovered [source: Cleveland Clinic].

Even so, there are some tests you can take to try to solve the mystery of your chronic hives. As with acute hives, your doctor can order blood and allergy tests to determine a cause. Additional tests might be necessary to rule out any underlying conditions, such as thyroid disease, that could be causing your hives [source: Mayo Clinic].

If your doctor can't find the cause of your chronic hives, then the treatment will become more about managing your symptoms than about finding a cure [source: Saini]. You will probably start out by trying some of the oral antihistamines that typically are used to treat acute hives. If they don't work, your doctor may prescribe corticosteroids, tricyclic antidepressants or a combination of antihistamines and H2 antagonists. The immune suppressant cyclosporine, the allergic asthma medication omalizumab and leukotriene receptor antagonists are currently being studied as potential treatments for chronic hives [source: Mayo Clinic].

Whether your hives are chronic or acute, you don't have to endure them alone. If you're suffering from hives, make an appointment with a doctor who can help you identify causes and treatments that will work for you.

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Hives in Five

Five fast facts about hives:

The size and duration of hives varies greatly.

Hives can swell to the size of a plate.

Smaller hives can join together to form a larger group of hives.

Hives can disappear within 24 hours to a few days or last for months or even years.